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421. Respiratory Epidemiology

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421. Respiratory Epidemiology Thematic Poster Session Hall 2-29 - 12:50-14:40 TUESDAY,SEPTEMBER 27TH 2011 Technology (NTNU), Trondheim, Norway; 3HUNT Research Centre, Norwegian University of Science and Technology (NTNU), Levanger, Norway Background: Anxiety is common among people with obstructive lung diseases. However, reduced lung function in combination with anxiety in relation to the reporting of dyspnoea is not well studied. Objectives: To study the association between reduced lung function and dyspnoea, and how anxiety affects this association. Methods: We analysed data on 5627 women and 5066 men who participated in the Lung substudy of the Nord-Trøndelag Health Study in 1995-97. In a cross- sectional design we used logistic regression to calculate multivariably adjusted odds ratios (ORs) for dyspnoea associated with levels of FEV1% predicted and anxiety (measured by the Hospital Anxiety and Depression scale). Results: Among women with FEV1 ≥100% predicted, those who had anxiety had an OR (95% confidence interval) for reporting dyspnoea when walking of 2.00 (0.68-5.90) compared to those without anxiety. Using the same reference group (FEV1 ≥100% predicted and no anxiety), women with FEV1 80-99% predicted had an OR of 2.46 (1.26-4.83) without anxiety and 7.67 (3.66-16.08) with anxiety, whereas those with FEV1 50-79% predicted had an OR of 4.61 (2.49-8.52) with- out anxiety and 14.37 (6.50-31.78) with anxiety. The corresponding ORs among men without and with anxiety were 1.00 (reference) and 4.55 (0.87-23.70); 1.15 (0.46-2.88) and 5.00 (1.82-13.73); and 4.10 (1.49-11.29) and 14.03 (4.04-48.76), respectively. The ORs for reporting dyspnoea at rest and waking up by dyspnoea showed similar patterns in both women and men. Conclusions: Reduced lung function in combination with anxiety had a stronger association with dyspnoea than reduced lung function alone. P4113 Functional health status and satisfaction with health in a population reporting a participation or activity limitation: Focus on COPD Donna Goodridge1, Joshua A. Lawson2, Darcy Marciniuk3, Donna C. Rennie2, Koroush Madani3. 1College of Nursing, 2Canadian Centre for Health and Safety in Agriculture, College of Medicine, 3College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada Background: Symptoms associated with COPD can result in participation and activity limitations as well as reduced quality of life. 421. Respiratory epidemiology: quality of life, Objective: To examine the impact of COPD on functional health status (FHS) and satisfaction with health (SWH) in persons with a participation or activity limitation therapy and socioeconomics among a national sample of Canadians. Methods: This survey used data from the 2006 Participation and Activity Lim- itation Survey (PALS), a complex population survey of Canadians reporting a disability on the census. COPD was present if there was a self-report of COPD, P4111 emphysema, or bronchitis as the cause of disability. FHS was assessed using Late-breaking abstract: Postmenopausal hormone replacement therapy is the Health Utility Index (HUI-3) and categorized as high, moderate, or severe. associated with increased risk of asthma hospitalization SWH was categorized as high, moderate, or low. Analyses were weighted to the Klaus Bønnelykk1, Ole Raaschou-Nielsen2, Hans Bisgaard1, Anne Tjønneland2, population and bootstrapping used to estimate variances. Kim Overvad3,4, Zorana J. Andersen2. 1Danish Pediatric Asthma Centre, Results: The sample represents 5,185,980 adults with participation or activity Copenhagen University Hospital, Gentofte, Democratic Peoples Republic of limitation. Subjects without missing data (55%) for the variables of interest were Korea; 2Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, included. COPD was reported as the reason for disability in 1.4% of the popu- Denmark; 3School of Public Health, Aarhus University, Aarhus, Denmark; lation. Among those reporting COPD, 44% reported moderate and 49% reported 4Centre for Cardiovascular Research, Aalborg Hospital, Aalborg University, low SWH. FHS was moderately impaired for 31% and severely impaired for 46%. Aalborg, Denmark After adjustment, COPD was significantly associated with a lower SWH (p<0.05), but not with FHS (p=0.12). Background: Postmenopausal hormone replacement therapy (HRT) has been Conclusions: While FHS was similar to the overall population with a disability, associated with asthma, but is not yet an established risk factor. persons with COPD had a markedly lower SWH, suggesting the need to focus on Aim: To investigate, for the first time, the association between HRT use and risk quality of life enhancement strategies. of severe asthma exacerbations requiring hospitalization in a prospective study. COPD was analyzed simultaneously to account for potential misclassification. Methods: Intake of HRT and potential confounders, including smoking status, P4114 occupational exposure, educational level, body mass index, and hysterectomy, were Lung function decline predicts disability in valued life activities, which in assessed in 1993-1997 in 23 138 postmenopausal women from the Danish Diet, turn predicts impaired quality of life in COPD Cancer and Health cohort. Incident (first-ever) asthma and COPD hospitalizations Paul D. Blanc 1, Jonathan Singer1, Theodore A. Omachi1, Gabriella Sanchez2, were registered prospectively in Danish Hospital Discharge Register between 1993 Carlos Iribarren2 , Miriam Cisternas3, Patricia P. Katz1. 1Medicine, University of and 2006. Association with HRT was analyzed with Cox’s regression analyses. California San Francisco, San Francisco, CA, United States; 2Kaiser Division of Results: We observed 446 (1.9%) incident asthma hospitalizations in 23 138 Research, Kaiser Permanente, Oakland, CA, United States; 3MGC Data Services, women over 9.9 years mean follow-up. 11 575 (50.0%) women ever used HRT. MGC Data Services, Carlsbad, CA, United States Ever using HRT was positively associated with asthma hospitalization (hazard ratio [95% confidence interval]: 1.37 [1.14-1.65]). The risk was highest with the longest Background: Interrelationships among lung function, disability, and health-related duration of HRT use (≥ 10 years: 1.51 [1.15-1.98], 3-10 years: 1.34 [1.05-1.72], < quality of life (HRQL) in COPD need clearer delineation. 3years: 1.29 [1.00-1.67], reference never users). Effect modification was detected Methods: We carried out baseline/follow-up interviews, spirometry, and 6 minute by smoking, indicating strongest effect in never smokers (1.84 [1.32-2.56]) and no walk tests (6MWT) for 646 participants in a COPD cohort (42% male; age 59±6; effect in current smokers (1.08 [0.79-1.45]). HRT was also associated with COPD median follow-up 2.1 years). Valued Life Activities (VLA) disability was scored hospitalization, with a smaller effect (1.19 [1.05-1.35]). with a validated instrument; VLA increased disability [VLA-ID]=0.5 standard Conclusion: HRT use may cause asthma onset or worsening with severe exacer- deviation increase in score baseline-follow-up (14.6% disability). We assessed bation. respiratory-specific HRQL with the Airways Questionnaire 20-Revised. Logistic regression (including age, sex, height) estimated risk by change in absolute values of FEV1 and 6MWT for VLA-ID; linear regression (including the same covariates, P4112 VLA-ID, and baseline HRQL) predicted follow-up HRQL. Lung function and anxiety in association with dyspnoea – The HUNT study Results: Mean decline in FEV1=-91 ml; mean decline in 6MWT=-37 M. VLA-ID 1 2 1 1 Linda Leivseth , Tom Ivar Lund Nilsen ,Xiao-MeiMai , Roar Johnsen , predicted worsened HRQL (p<0.001). Although FEV1 decline predicted VLA-ID 3 1 Arnulf Langhammer . Department of Public Health and General Practice, (p<0.001), neither change in FEV1 or 6MWT was associated with change in Norwegian University of Science and Technology (NTNU), Trondheim, Norway; HRQL. Including FEV1 and 6MWT in multivariate modeling, VLA-ID retained 2Department of Human Movement Science, Norwegian University of Science and its relationship with HRQL (1.3 point change; effect size=0.29; p<0.001). 752s Abstract printing supported by . Visit Chiesi at Stand D.30 Thematic Poster Session Hall 2-29 - 12:50-14:40 TUESDAY,SEPTEMBER 27TH 2011 Conclusion: VLA-ID, but not FEV1 or 6MWT decrements, predicted HRQL P4117 impairment. Although FEV1 decline was associated with VLA-ID, worsening The restrictive spirometric pattern is associated with impaired health-related respiratory status did not directly account for HRQL changes. quality of life Clinical Relevance: Interventions directly focused on attenuating disability are Stefano Guerra1, Anne-Elie Carsin1, Jan-Paul Zock1, Benedicte Leynaert2, likely to be critical in preserving HRQL, independent of respiratory function or Christer Janson3, Deborah Jarvis4,JosepM.Anto1. 1Centre for Research in exercise capacity. Environmental Epidemiology, CREAL, Barcelona, Spain; 2INSERM, U700, Support: NIH HL077618, FAMRI CoE2007. Faculté Paris Diderot, Paris VII, Paris, France; 3Department of Medical Sciences: Respiratory Medicine & Allergology, Uppsala University, Uppsala, Sweden; 4National Heart and Lung Institute, Imperial College, London, United Kingdom P4115 Recreational activity limitation in subjects with and without COPD in five Previous population-based studies have shown that a restrictive spirometric pattern Latin American cities: The PLATINO study is present in a significant proportion of the adult population and is associated M. Montes de Oca1,C.Talamo1,D.Moreno1, A. Menezes2,
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